OBJECTIVES: To evaluate the applicability and the effectiveness of practice guidelines based on a wait-and-see strategy for children with acute otitis media (AOM). POPULATION: Children from 1 to 14 years old having AOM who were referred to primary care pediatric practices. STUDY DESIGN: Prospective observational study. MAIN OUTCOME MEASURE: Proportion of children having a diagnosis of AOM and eligible for symptomatic treatment who, at 72 hours from enrollment, recovered from their symptoms (fever and earache) without receiving antibiotic treatment. RESULTS: One hundred sixty-nine pediatricians participated in the study and enrolled 1672 children. One thousand two hundred seventy-seven children were included in the analysis. One hundred seventy-eight children received antibiotic treatment at first contact according to the practice guidelines criteria (presence of otorrhea or recurrent AOM). Of the 1099 children who were eligible for symptomatic treatment only, 743 (67.6%) recovered without antibiotic treatment at 3 days and 716 (65.1%) at 30 days. No complications were observed. Coexistence of a high fever (temperature > or = 38.4 degrees C) and red and bulging tympanic membrane as well as male sex were significantly associated with antibiotic use. CONCLUSIONS: Practice guidelines based on a wait-and-see strategy for children with AOM are applicable and effective in primary care. This strategy was able to avoid the administration of antibiotic treatment in 2 of 3 children.
OBJECTIVES: To evaluate the applicability and the effectiveness of practice guidelines based on a wait-and-see strategy for children with acute otitis media (AOM). POPULATION: Children from 1 to 14 years old having AOM who were referred to primary care pediatric practices. STUDY DESIGN: Prospective observational study. MAIN OUTCOME MEASURE: Proportion of children having a diagnosis of AOM and eligible for symptomatic treatment who, at 72 hours from enrollment, recovered from their symptoms (fever and earache) without receiving antibiotic treatment. RESULTS: One hundred sixty-nine pediatricians participated in the study and enrolled 1672 children. One thousand two hundred seventy-seven children were included in the analysis. One hundred seventy-eight children received antibiotic treatment at first contact according to the practice guidelines criteria (presence of otorrhea or recurrent AOM). Of the 1099 children who were eligible for symptomatic treatment only, 743 (67.6%) recovered without antibiotic treatment at 3 days and 716 (65.1%) at 30 days. No complications were observed. Coexistence of a high fever (temperature > or = 38.4 degrees C) and red and bulging tympanic membrane as well as male sex were significantly associated with antibiotic use. CONCLUSIONS: Practice guidelines based on a wait-and-see strategy for children with AOM are applicable and effective in primary care. This strategy was able to avoid the administration of antibiotic treatment in 2 of 3 children.
Authors: S Di Mario; V Basevi; R D'Amico; C Gagliotti; M Gangemi; F Marchetti; M L Moro; G Tamburlini Journal: Eur J Clin Microbiol Infect Dis Date: 2016-05-14 Impact factor: 3.267
Authors: Beth Stuart; Hilda Hounkpatin; Taeko Becque; Guiqing Yao; Shihua Zhu; Pablo Alonso-Coello; Attila Altiner; Bruce Arroll; Dankmar Böhning; Jennifer Bostock; Heiner C Bucher; Jennifer Chao; Mariam de la Poza; Nick Francis; David Gillespie; Alastair D Hay; Timothy Kenealy; Christin Löffler; David P McCormick; Gemma Mas-Dalmau; Laura Muñoz; Kirsty Samuel; Michael Moore; Paul Little Journal: BMJ Date: 2021-04-28
Authors: Faris F Brkic; Gerold Besser; Martin Schally; Elisabeth M Schmid; Thomas Parzefall; Dominik Riss; David T Liu Journal: J Med Internet Res Date: 2021-06-24 Impact factor: 5.428